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Updated: May 11, 2026

Computed Tomography (CT) Guided Implantation of a Totally Implantable Venous Access Port (TIVAP) through Subclavian Vein
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Computed Tomography (CT) Guided Implantation of a Totally Implantable Venous Access Port (TIVAP) through Subclavian Vein

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[The difficult venous access]

Jochen M Strauß1, Andrea Denk

  • 1Klinik für Anästhesie, perioperative Medizin und Schmerztherapie, HELIOS Klinikum Berlin-Buch. jochen.strauss@helios-kliniken.de

Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
|May 2, 2013
PubMed

Insights

Pediatric venipuncture is challenging due to anatomical factors and patient movement. Ultrasound and intraosseous (IO) access offer effective solutions for establishing intravenous access in children.

Area of Science:

  • Pediatric Anesthesiology
  • Vascular Access Techniques
  • Medical Imaging in Pediatrics

Context:

  • Venipuncture in children presents significant challenges due to factors like subcutaneous fat and patient movement.
  • Difficult venous access necessitates advanced techniques for effective pediatric care.
  • Intraosseous puncture is a recognized standard for rapid vascular access in pediatric anesthesia.

Purpose:

  • To explore technical devices and methods for improving pediatric venipuncture success rates.
  • To highlight the utility of ultrasound in visualizing deep peripheral veins for cannulation.
  • To emphasize the importance of sedation and proper training for pediatric vascular access.

Summary:

  • Ultrasound can identify and guide puncture of deep peripheral veins in children's wrists and ankles.
  • Adequate sedation is crucial for managing pediatric patient movement during venipuncture.
  • Intraosseous puncture provides rapid and secure vascular access in pediatric emergencies and anesthesia.

Impact:

  • Improved success rates for establishing intravenous access in pediatric patients.
  • Reduced patient distress and procedural time through effective venous access strategies.
  • Enhanced safety and efficiency in pediatric emergency care and anesthesia through advanced techniques.

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